Every mother-baby pair is different! That makes it hard to say exactly how your baby should be eating. In the first few days, your baby is getting rich, yellow colostrum (first milk). Signs that your baby is getting enough milk are:

One or two periods per day when your baby is alert, bright-eyed, and looking at your face

A baby who wants to eat every 1-3 hours and is generally satisfied between feedings, however--it is common for newborns to “cluster feed” (need to be breastfeeding very frequently) for a daily 4-6 hour stretch, often followed by a long period of sleep. This is normal behavior and helps stimulate an ample milk supply as your baby becomes an expert at latching and removing milk.

Nurse at least 8-12 times in 24 hours

At least 3-4 wet diapers per day by day 3 of life

The normal change in stools over the first 2-5 days of life: meconium (dark green, tarry) to transitional stools (lighter green or brown) to true breastmilk stools (yellow, seedy, or loose). The number of stools will increase each day.

We often assume that breastfeeding is such a natural process that anyone should be able to do it. The truth is, breastfeeding is a learned process for both mother and baby. Preparing for success before your baby’s birth-- by reading, taking classes, and attending a support group-- will help you to know what is normal and how to prevent common problems. If challenges do arise they can most often be minimized or managed with skilled help.

Talk to your midwife, doctor, or birth attendants about your plans to breastfeed and find out what kind of breastfeeding support is available at the place and time you give birth. Partners and grandparents can also be included in learning how to encourage your success! There are a variety of breastfeeding support services that offer information, support, and technical assistance, both before and after your baby is born. This is a guide to those services.

BREASTFEEDING CLASSES

Prenatal breastfeeding classes can provide general information on breastfeeding basics, teach ways to make it easier, and suggest ways to solve problems. Knowing the normal course of breastfeeding and how to avoid the most common pitfalls before the baby is born will lead to a longer, more satisfying breastfeeding experience. The knowledge and confidence you get is worth the few hours you will spend in a prenatal class.

Classes may be offered as part of a childbirth preparation series, as a separate class at a hospital, as a part of WIC services, or be taught privately. Fees may vary, or the classes may be free. Small group classes are best. Bring the baby\'s father, a friend or family member with you. Classes may include demonstration of techniques. After your baby is born, a follow-up by phone or personal consult may be included. You can use this directory or ask your childbirth educator, hospital or health care provider for a referral.

More information can be found in good breastfeeding books, recommended websites, and from other successful nursing mothers. Mother-to-mother support groups like La Leche League are also a good place to observe breastfeeding styles and learn practical tips. See this directory for phone numbers and visit our website for more links to helpful websites, articles, resources and information for parents and professionals: www.breastfeeding.org

YOUR MILK SUPPLY You may feel that you do not have any milk in your breasts for the baby during the first few days. YOU DO! During pregnancy your body has been preparing for feeding your baby by producing colostrum, or \"first milk\". This rich yellowish fluid is perfect for your newborn’s needs. Holding your baby skin-to-skin right after delivery is a powerful and important way to help you both recover from the delivery process and get breastfeeding started. If medical needs of mom or baby prevent you from having this special time in the first few hours, then be sure to ask to hold your baby skin-to-skin as soon as you both are stable.

Continue to enjoy lots of skin-to-skin time with your newborn, especially at feeding times. This actually increases the levels of important bonding and milk-making hormones, and increases long-term breastfeeding success!

After 2-4 days the colostrum begins to change into \"mature\" milk and gradually becomes bluish-white. Breastmilk is both food and drink to your baby, and breastfeeding provides warmth and comfort as well. It is balanced to meet all your baby\'s needs, and changes according to your baby\'s age. When your milk starts \"coming in\" your breasts may become very firm and feel warm and tender. This is due to more blood supply, some swelling, and the milk. Feeding your baby often will relieve the fullness.

If your breasts become very full, your baby may have trouble getting on the breast (latching-on). Apply warm, wet towels or take a warm shower to start your milk flowing. Try expressing some milk by hand or use a breast pump briefly to soften your breasts. Cold, wet towels or ice bags after feedings may reduce swelling. Breast fullness should decrease as your baby learns to empty your breasts. If your breasts are still very full and tender after 1-2 days, call your lactation specialist or doctor for help.

BREASTFEEDING (LACTATION) SPECIALISTS

Finding and choosing a breastfeeding professional can be a confusing matter. There are many people offering services to help you breastfeed. They may call themselves Lactation Educator, Lactation Consultant, or Lactation Specialist. To find a qualified person that you can work with, consider the following:

Academic Credentials and Experience: What kind of education about breastfeeding do they have? Where did they get their training? A practitioner may have no formal training, may have taken a university certification course, may have passed a written certification exam, or taken a correspondence course. They may be a doctor (MD), nurse (RN, LVN), nurse practitioner (NNP, CPNP), certified nurse midwife (CNM), registered dietitian (RD), occupational therapist (OT), certified lactation educator (CLE), certified lactation consultant (CLC) or international board certified lactation consultant (IBCLC-the gold standard), or certified lactation specialist. You can ask to see their credentials if you wish. Training and experience vary widely, so ask about it. How does the practitioner keep up with the current research and issues in breastfeeding? Is the practitioner currently a member of a professional lactation organization?

Services: What kinds of services do they offer? Classes, in-person home or office consults, phone counseling, rental and/or sale of breast pumps or other breastfeeding accessories are possible. Where are services provided? Are home or hospital visits made? When are services available? Can you get help on evenings, weekends, or holidays? Is the practitioner affiliated with a hospital or medical group?

Fees: What are the fees for the various levels of service? Costs may be eligible for insurance reimbursement. Fee schedules vary, so shop around. Ask for an official bill to submit to your insurance carrier.

PROVIDERS OF BREASTFEEDING (LACTATION) SERVICES

Although listed by address, the sources listed below provide services throughout San Diego County. The credentials listed after their names are listed as the individual requested and have not been verified by the San Diego County Breastfeeding Coalition. The San Diego County Breastfeeding Coalition does not certify or guarantee any services provided. Some breastfeeding services accept insurance and Medi-Cal. Ask when you call. *Spanish spoken

Caring support in your home to meet your breastfeeding goals. Over 10 years experience with moms and babies specializing in positioning and latch, milk supply maintenance, preterm and late preterm infants. Aetna Preferred Provider.

Latching With Love, by Wendy Colson RN, IBCLCNurse Wendy has over 18 years’ experience helping moms and babies; specializing in pre-term and term suck issues, latch difficulties, lip and tongue-tie management, office and private in-home consultations , monthly prenatal classes, corporate lactation programs, community mentor for nursing and lactation students, and a free weekly support group located at the Cap Wellness Center (Dr. Capetanakis) in Encinitas every Thursday. ACCEPTS MOST INSURANCES

Baby Steps & Breastfeeding (619) 672-7077 Barbara Hale RN, IBCLC, CCEBarbara has over 25 years of experience working mothers, babies and families. Offering private in home lactation consultations county wide. Prenatal evaluations and breastfeeding education along with pregnancy and parenting support available.babystepsandbreastfeeding@gmail.com Contact by phone or E-mail

200 West Arbor Drive, San Diego, CA 92103. Lactation consults; help for special needs mothers and infants; breastfeeding classes; support group meets every Tuesday from 10 AM – 12 PM at Thornton Hospital; staff and client education. Call 800-926-8273 to learn more

Limerick - Offers the leading national Workplace Lactation Program and designs and manufactures PJ’s Comfort ® Hospital Grade (multi-user) breast pump, a lightweight 1 - ½ lb unit that goes from hospital to home to work. www.Limerickinc.com

Medela – Medela, Inc. (800) 435-8316. A long-time champion of breastfeeding, Medela is the only company to develop products based on research by the world’s leading lactation experts. http:///www.medelabreastfeedingus.com

Ameda - Ameda Breastfeeding offers the most safe and effective breast pumps and accessories available to today\'s modern hospitals, retailers and WIC agencies. For more than 65 years, Ameda products have been used by mothers and professionals to achieve breastfeeding goals. To learn more about Ameda products and breastfeeding programs, contact Ame Raila at (818) 512-6824. www.ameda.com